Table 1 Summary of findings of included studies in China
Author | Rounds | Study disease | Study drugs | Setting | Study design | Outcomes | Key findings |
|---|---|---|---|---|---|---|---|
Zhang et al., 2021 [21] | 2017 | - | 15 anticancer drugs | 789 public hospitals from 30 provinces | CITS | DDDc; DDDs; expenditure | The DDDc of price-negotiated medications decreased by 48.9%.The DDDS increased by 143.0%.The hospital medication spending decreased by 6.9% |
Sun et al., 2022 [11] | 2017 | - | rituximab, trastuzumab, and recombinant human endostatin (RHE), | 11 provinces | CITS | Monthly; average expenditure; DDDS; Availability | The monthly expenditures of rituximab increased by 6.0% The volume and availability of rituximab increased by 949.6 DDDs and 1.56%, respectively. The availability of trastuzumab increased by 5.14% immediately |
2016 | lung cancer | gefitinib, icotinib | Fuzhou city | ITS | The monthly number of patients adopting gefitinib and icotinib; OOP expenditure share | The monthly number of patients using gefitinib and icotinib increased by 26. The OOP expenditure share patients covered by UEMI and URRMI were higher than patients with government-funded supplementary | |
Fang et al., 2021 [24] | 2017 | - | 15 innovative anti-cancer medicines | Nanjing city | ITS | DDDc; DDDs; Availability; Affordability of patients | The DDDc reduced 34% ~ 65%.The DDDs of most drugs increased. The availability rate increased form 27.44% to 47.33%.The affordability of patients improved |
Diao et al., 2021 [25] | 2017 | breast cancer | trastuzumab | A tertiary public hospital in Fujian province | ITS | The monthly proportion of patients adopting study medicines; Determinants of patient’s medication choice | The monthly proportion of patients adopting study medicines increased by 18.3%. The gaps of the proportions of patients adopting study medicines between the urban and rural areas, and among the patients enrolled in different health insurance programs diminished. The critical determinants of patient’s medication choice were patient’s health insurance benefits packages |
C. Huang et al., 2021 [26] | 2016 | lung cancer | icotinib and gefitinib | 594 tertiary hospitals from 29 provinces | ITS | DDDc; DDDs; expenditure | The DDDC of icotinib and gefitinib decreased by 50.08% and 53.89%.The volume increased 4.87 thousand DDDs and 6.89 thousand DDDs. The monthly purchasing spending decreased rapidly by US$0.51 million and US$0.82 million |
Zhu et al., 2022 [6] | 2017 | - | 18 anticancer drugs | 31 provinces (nationwide) | ITS | Accessibility; DDDc; | The overall availability increased by 30%;The average DDDc dropped by 23.88%.Drug availability experienced a larger instant and slope increase in Western Medicines and in secondary hospitals |
Liu et al., 2022 [18] | 2016; 2018 | Lung Cancer | gefitinib, bevacizumab and recombinant human endostatin | Nanjing city | ITS | DDDs; DDDc; Availability; Affordability | The DDDs of the three drugs increased significantly. The trend of DDDc showed a significant decrease. The mean availability of these drugs increased form 30% to 60.33%.The financial burden is higher for the rural patients compared with the urban patients, although the gap is narrowing |
Mao et al., 2021 [27] | 2019 | - | 70 negotiated drugs | Hubei Provinces | ITS | Expenditure; DDDs; DDDc | The expenditure increases by 61.48%.The DDDs increased by 4.85 times. The DDDc decreased 72.38% |
Feng et al., 2020 [51] | 2018 | Hepatitis C | - | Tianjin and Chengdu city | ITS | Total healthcare expense; Medicine expense; other expense | In Tianjin, the total, drug and other expense dropped significantly. In Chengdu, the total expense and drug expense increased significantly |
Chen et al., 2018 [28] | 2017 | All patients | - | A Tertiary Oncology Institution in Beijing | ITS | The number of outpatients; Average expense; Auxiliary drug share; Drug expense share; OOP share | The number of outpatients rose by 20. The average expense for outpatient and inpatient dropped by 33.44 CNY and 468.75 CNY respectively. The auxiliary drug share, drug expense share, and OOP share decreased |
2017 | HER 2 positive breast cancer | trastuzumab, lapatinib | Fuzhou city | ITS | The number of patients adopting study medicines; OOP expenditure share | The number of patients adopting study medicines increased 24. The OOP expenditure share of patients enrolled in URRMI were higher than patients with government budget funded supplementary | |
Liu et al., 2020 [52] | 2018 | lung cancer | 5 anticancer drugs | A tertiary hospital in Shanghai city | ITS | Drug costs | The average drug cost decreased by 28,200 CNY in outpatient and emergency departments; The average drug cost decreased by 16,700 CNY in inpatient department |
Cao et al., 2020 [35] | 2018 | lung cancer | 5 anticancer drugs | A tertiary hospital in Shanghai city | ITS | The number of patients adopting study medicines; The proportion of genetic test | The number of patients adopting study medicines increased; The proportion of genetic test increased from 9.93% to 19.42% |
Diao et al., 2022 [29] | 2017 | breast cancer | trastuzumab | Fujian province | PSM | Medical expenditure; OOP expenditure share; The proportion of patients who adopted trastuzumab | The medical expenditure decreased by US$18,661.02. The OOP expenditure share decreased by 24%. The proportion of patients who adopted trastuzumab increased from 29.9% to 61.8%. Patients enrolled in URRHI benefit less form the policy |
Cai et al., 2022 [30] | 2018 | - | 17 anticancer medicines | 31 provinces (nationwide) | CITS | Availability; DDDs; DDDc; Affordability | The availability increase by 25.22%.The utilization of the medicines increased by 11.44 DDDs. The DDDc decreased by US$109.09. The affordability ratio decreased from 17.35 to 1.99 |
2017 | - | Six types of anti-HER2 drugs | Nanjing | ITS | DDDs; DDDc | The DDDs anti-HER2 drugs increased. The DDDc decreased | |
Ding et al., 2022 [32] | 2017 | cancer | - | four cities in Shandong province | ITS | The outpatient and inpatient care visits per capita; The proportion of OOP expenditure; The proportion of medication costs; | The outpatient care visits per capita significantly decreased. The proportion of OOP expenditure in outpatient medical costs decreased. The proportion of OOP expenditure in inpatient medical costs increased. The proportion of medication costs in outpatient medical costs rose by 0.28%.The proportion of medication costs in inpatient medical costs decreased 0.2% |
Liu et al., 2023 [33] | 2021 | - | lenvatinib | Nanjing city | ITS | The utilization of lenvatinib; The total hospitalization expenses | The NHIC policy has significantly increased the utilization of lenvatinib. The total hospitalization expenses increased |
Yang et al., 2023 [34] | 2017 | cancer | targeted anticancer medicines | 31 provinces (nationwide) | ITS | Price-negotiated TAMs use, Direct medical costs | The government price negotiation and reimbursement policy improved patient access to targeted anticancer medicines and narrowed disparities among insurance schemes. TAMs users’ daily medical costs increased |